Diagnostic role of magnetic resonance imaging in identifying aortic arch anomalies.
Diagnostic role of magnetic resonance imaging in identifying aortic arch anomalies.
复制标题
磁共振成像在识别主动脉弓异常中的诊断作用。
DOI：
10.1111/j.1747-0803.2008.00174.x
复制
发表时间：
2008
影响因子：
0.3
通讯作者：
R. Razavi
中科院分区：
文献类型：
--
作者：
M. Cantinotti;S. Hegde;Aaron J. Bell;R. Razavi
目的
本文旨在评估MRI在诊断和治疗各种复杂主动脉弓异常中的作用。
材料和方法
在1.5T Philips Gyroscan Intera上进行成像。我们回顾性分析了2003年11月至2007年2月在我们研究所进行的所有心脏MR扫描，以识别主动脉弓异常。磁共振成像包括三维（3D）矢状容积图像、电影图像、短轴心室容积、大血管相位对比血流和3D钆磁共振血管造影。
结果
在47例患者中确定了三大类异常：双主动脉弓（n = 9）、右侧主动脉弓伴镜像分支（n = 28）和迷走右锁骨下动脉（n = 10）。在双主动脉弓组中，6名患者有症状，其中4名接受了手术分割。磁共振成像用于计划手术治疗。在其他两组中，没有患者出现气道或食管压迫症状，并且在其他相关心脏疾病的调查过程中发现了弓异常。然而，我们注意到与明确定义的先天性心脏病亚组有很强的相关性。右侧主动脉弓见于肺动脉闭锁伴室间隔缺损（46.4%）、法洛四联症（32.1%）和右心室双出口伴右心房异构（14.2%）患者。70%的迷走右锁骨下动脉患者有主动脉缩窄，1例主动脉弓完全中断。
结论
磁共振成像是识别主动脉弓及其分支异常的重要诊断工具，在计划手术治疗时，特别是当存在相关心脏异常时，可被视为首选的成像技术。
PURPOSE
The aim of this article was to assess the role of MRI in the diagnosis and management of a variety of complex aortic arch anomalies.
MATERIALS AND METHODS
Imaging was performed on a 1.5T Philips Gyroscan Intera. We retrospectively reviewed all cardiac MR scans performed from November 2003 to February 2007 at our institute to identify aortic arch anomalies. Magnetic resonance imaging included three-dimensional (3D) sagittal volume images, cine images, short axis ventricular volumes, phase contrast flow of great vessels, and 3D gadolinium magnetic resonance angiogram.
RESULTS
Three major categories of anomalies were identified in 47 patients: double aortic arch (n = 9), right-sided aortic arch with mirror image branching (n = 28), and aberrant right subclavian artery (n = 10). In the double aortic arch group, six patients were symptomatic, and four of them underwent a surgical division. Magnetic resonance imaging was used to plan the surgical management. In the other two groups, no patient presented with symptoms of airway or esophageal compression, and the arch abnormalities were noticed during investigation for other associated cardiac disease. However, we noticed a strong correlation with well-defined subgroups of congenital heart disease. Right-sided aortic arch was seen in patients with pulmonary atresia with ventricular septal defect (46.4%), tetralogy of Fallot (32.1%), and double outlet right ventricle with right atrial isomerism (14.2%). Seventy percent of the patients with aberrant right subclavian artery had aortic coarctation, and another case presented a complete aortic arch interruption.
CONCLUSION
Magnetic resonance imaging is an important diagnostic tool in identifying anomalies of the aortic arch and its branches and can be considered the imaging technique of choice when planning surgical management, especially when there are associated cardiac anomalies.